1 vaginal retractor.
1 vulsellum forceps.
1 long uterine douche point.
2 dull curettes.
2 sharp curettes of different sizes, together with gauze for packing the uterus.
Rubber gloves should be worn both by nurse and physician as much for personal protection as for the patient’s safety. In many cases of incomplete abortion or of puerperal sepsis the endometrium is more satisfactorily curetted with the gloved fingers.
Abortion may be indicated in many of the early complications of pregnancy, such as hyperemesis, nephritis, uncompensated heart lesions, tuberculosis, insanity, hydramnios, incarcerated retroversions of the uterus and the presence of hæmorrhage. These cases require the operation to be undertaken and finished by the doctor, but other conditions develop wherein, without volition on the part of the patient or doctor, the abortion begins. Some may be saved, but at times the attempt is futile.
If the emptying of the uterus seems inevitable, the function of the physician is to see that the process is finished as quickly and cleanly as possible.
This may be done in the early stages by packing the cervix and vagina with iodoform gauze and administering ergot in twenty-five drop doses thrice daily.
In case of dangerous hæmorrhage from spontaneous abortion, the vagina can be tamponed with cotton pledgets or gauze by a clean nurse while awaiting the arrival of the doctor.